Healthcare Provider Details

I. General information

NPI: 1881664100
Provider Name (Legal Business Name): MEDICAL EYE CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 10/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 KNOLLWOOD TRL W
MENDHAM NJ
07945-3038
US

IV. Provider business mailing address

12 KNOLLWOOD TRL W
MENDHAM NJ
07945-3038
US

V. Phone/Fax

Practice location:
  • Phone: 973-543-1560
  • Fax:
Mailing address:
  • Phone: 973-543-1560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMA59654
License Number StateNJ

VIII. Authorized Official

Name: LINDA Y KALNINS
Title or Position: OWNER
Credential: M.D.
Phone: 973-543-1560